항생제 피부반응시험 양성인 경우 변경 항생제 분석
Evaluation of Changed Antibiotics in Case of Positive Antibiotics Skin Test
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background: Antibiotics skin test (AST) is routinely performed to examine hypersensitivity in clinical practice. However, it is difficult to select antibiotics in case of positive AST because of poor validation of AST, crossreactions among β-lactams, etc. Objective: To evaluate the change of antibiotics and following results in case of positive AST. Method: Eighty-six hospitalized patients with positive AST between June 2008 and May 2009 were enrolled. The changing patterns of antibiotics, skin test-reactivity of changed antibiotics, history of antibiotics allergy and adverse events after administration of antibiotics were examined in review of medical records. Result: The patients with positive AST were 95 cases. The skin test positive-antibiotics were 11 penicillins and 84cephalosporins, respectively. The finally administered antibiotics were changed in 84 patients except 2 patients, which were non β-lactams in 13 patients, cephalosporins in 59patients, and penicillins in 14 patients. Total 3 (3.5%)adverse reactions (ADRs) were reported. Among them, one was reported in 2 patients whose antibiotics were not changed and 2 (2.4%) in remaining 84 patients. Conclusion: Most antibiotics were changed and the changing patterns of antibiotics were varied in case of positive AST. The guidelines for changing antibiotics are needed.
Abstract
Background: Antibiotics skin test (AST) is routinely performed to examine hypersensitivity in clinical practice. However, it is difficult to select antibiotics in case of positive AST because of poor validation of AST, crossreactions among β-lactams, etc. Objective: To evaluate the change of antibiotics and following results in case of positive AST. Method: Eighty-six hospitalized patients with positive AST between June 2008 and May 2009 were enrolled. The changing patterns of antibiotics, skin test-reactivity of changed antibiotics, history of antibiotics allergy and adverse events after administration of antibiotics were examined in review of medical records. Result: The patients with positive AST were 95 cases. The skin test positive-antibiotics were 11 penicillins and 84cephalosporins, respectively. The finally administered antibiotics were changed in 84 patients except 2 patients, which were non β-lactams in 13 patients, cephalosporins in 59patients, and penicillins in 14 patients. Total 3 (3.5%)adverse reactions (ADRs) were reported. Among them, one was reported in 2 patients whose antibiotics were not changed and 2 (2.4%) in remaining 84 patients. Conclusion: Most antibiotics were changed and the changing patterns of antibiotics were varied in case of positive AST. The guidelines for changing antibiotics are needed.
참고문헌 (22)
- Greenberger PA, "Drug allergy", J Allergy Clin Immunol, 117, pp.S464~S470 (2006)
- Gadde J, "Clinical experience with penicillin skin testing in a large inner-city STD clinic", JAMA, 270, pp.2456~2463 (1993)
- Sogn DD, "Results of the national institute of allergy and infectious diseases collaborative clinical trial to test the predictive value of skin testing with major and minor penicillin derivatives in hospitalized adults", Arch Intern Med, 152, pp.1025~1032 (1992)
- Salkind AR, "The rational clinical examination. Is this patient allergic to penicillin? An evidencebased analysis of the likelihood of penicillin allergy", JAMA, 285, pp.2498~2505 (2001)
- Levine BB, "Prediction of penicillin allergy by immunological tests", J Allergy, 43, pp.231~244 (1969)
- Romano A, "Cross-reactivity and tolerability of cephalosporins in patients with immediate hypersensitivity to penicillins", Ann Intern Med, 141, pp.16~22 (2004)
- Antunez C, "Immediate allergic reactions to cephalosporins: evaluation of cross-reactivity with a panel of penicillins and cephalosporins", J Allergy Clin Immunol, 117, pp.404~410 (2006)
- Romano A, "Allergic reactions to ampicillin. Studies on the specificity and selectivity in subjects with immediate reactions", Clin Exp Allergy, 27, pp.1425~1431 (1997)
- Gruchalla RS, "Clinical practice. Antibiotic allergy", N Engl J Med, 354, pp.601~609 (2006)
- Kelkar PS, "Cephalosporin allergy", N Engl J Med, 345, pp.804~809 (2001)
- Audicana M, "Allergic reactions to betalactams: studies in a group of patients allergic to penicillin and evaluation of cross-reactivity with cephalosporin", Allergy, 49, pp.108~113 (1994)
- Celik G, "Drug allergy, In Middleton's allergy principle and practice. 7th ed", pp.1205~1226 (2009), Mosby
- Blanca M, "Update on the evaluation of hypersensitivity reactions to betalactams", Allergy, 64, pp.183~193 (2009)
- Novalbos A, "Lack of allergic cross-reactivity to cephalosporins among patients allergic to penicillins", Clin Exp Allergy, 31, pp.438~443 (2001)
- Empedrad R, "Nonirritating intradermal skin test concentrations for commonly prescribed antibiotics", J Allergy Clin Immunol, 112, pp.629~630 (2003)
- Schwindt CD, "Role of intradermal skin tests in the evaluation of clinically relevant respiratory allergy assessed using patient history and nasal challenges", Ann Allergy Asthma Immunol, 94, pp.627~633 (2005)
- Ditto AM, "Drug allergy, In Patterson's allergic disease. 7th ed", pp.238~314 (2009), Lippincott Williams & Wilkins
- Torres MJ, "Diagnosis of immediate allergic reactions to beta-lactam antibiotics", Allergy, 58, pp.961~972 (2003)
- Sullivan TJ, "Skin testing to detect penicillin allergy", J Allergy Clin Immunol, 68, pp.171~180 (1981)
- Sanchez-Sancho F, "Synthesis, characterization and immunochemical evaluation of cephalosporin antigenic determinants", J Mol Recognit, 16, pp.148~156 (2003)
- Goldberg A, "Skin testing and oral penicillin challenge in patients with a history of remote penicillin allergy", Ann Allergy Asthma Immunol, 100, pp.37~43 (2008)
- 이소희, "The Current Practice of Skin Testing for Antibiotics in Korean Hospitals", The Korean Journal of Internal Medicine, 25(2), pp.207~212 (2010), 대한내과학회